Individual
JAN REY ROA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10236 W PUGET AVE, PEORIA, AZ 85345-7351
(510) 440-1383
Mailing address
10236 W PUGET AVE, PEORIA, AZ 85345-7351
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP044874T
NJ
225100000X
Physical Therapist
LPT-32043
AZ
225100000X
Physical Therapist
PT293641
CA
Other
Enumeration date
03/30/2020
Last updated
06/03/2025
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